Aortic valve replacement surgery is potentially effective in treating severe aortic valve disease. It involves removal of the malfunctioned valve and replacing it with an artificial valve. These artificial valves are mainly of two types which include:
1.Biological or tissue valves: It is usually made out of the pig tissue or porcine, cow tissue or bovine. No blood thinners are required if these valves are placed. Although, upon an average biological valve lasts for around 15-20 years, post that another surgery might be required.
2.Mechanical valves: It is made up of carbon fiber and is very durable. Its failure chances are almost nil. Once mechanical valves are placed in the heart, then lifelong one has to be on anticoagulants or blood thinners like warfarin which in turn needs monitoring to avoid bleeding risks.
The decision of choosing a particular type of valve can turn out to be confusing. However, the surgeon can ultimately guide the patient to go for what is best as per the conditions and post discussion of the differences amongst both the types.
The situation of aortic valve replacement arises in a case when a patient is usually diagnosed with any of the followings:
Preparing for surgery
Before patient plans to undergo a surgery. The physician prefers a complete physical exam to analyze the condition along with some blood work and urine analysis, chest X-ray, electrocardiogram or EKG. All these are done to diagnose and rule out any other diseases which might complicate the surgical procedure later.
The patient must also discuss the complete disease and medical history along with any supplement intake of vitamins, herbal medicines or any diet pills. If required the physician might stop any of these pills temporarily or permanently to avoid any further complications.
Any small ailment like flu or common cold etc. might be informed prior surgery along with the habit of smoking if any, because these might cause breathing troubles or blood clots formation especially the smoking thing. So quitting smoking is best if not possible too soon than atlas temporarily quitting pre and post surgery is a mandatory requirement.
Besides, all these setting all things at home within easy reach helps post operation.
On the day of surgery
The patient is supposed to reach the hospital on the scheduled surgery date.
The aortic valve replacement surgery requires a general anesthesia to keep the patient asleep during the procedure. In this, an incision is made in the chest to access the heart although, its length and location vary as per the type of procedure selected.
The heart is temporarily stopped and then stopped after which the heart-lung bypass machine performs its job. The damaged aortic valve is then removed and replaced with an artificial one, then the heart is restarted and the incision opening in the chest is closed with the sutures.
Sometimes, after the aortic valve replacement, the surgeon might also perform coronary artery bypass or grafting in case it is required to avoid another surgery. However, in such scenarios possibilities of such requirements are discussed in pre-surgery appointment session.
The patient might experience soreness or stiffness at the incision site post operation. The burning sensation along with pain and pressure feeling might also be there in the chest, especially after the fluid drainage tubes are removed. Initially changing body postures can be troublesome and even sitting, coughing or walking can cause pain. Few small incisions if done in the neck or groin region during surgery can also cause pain later. The patient will be lying down during and after surgery, so this long duration of lay down might cause some discomfort in the chest, shoulder or back muscles.
The patient might even be suggested to follow a coughing and deep breathing techniques to expel the excess fluid out from the lungs. Also, temporary numbness in the chest, legs, arms or hands can appear because of nerve irritation caused by the line placement in the artery. But this numbness eventually fades over the period of time.
After the surgery, the patient will take some time to feel better. Since surgery comes as a sort of trauma for the body and the operated organ which is heart takes some time to gets back to its functioning gradually. The patient’s condition will be monitored under observation in the intensive care unit or ICU for 1-2 days. Later for the next 4-5 days, the patient will still remain under observation although room will be shifted from ICU to normal. The draining out of fluid around the heart is done with the help of 2-3 tubes, which are usually removed three days after the surgery. Complete recovery might take 2-3 months. The specific instructions are given by the treating physician or surgeon during discharge as per the case and recovery status of the patient.
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Q: What are the risks involved in the valve replacement surgery?
A: This procedure has some associated risks involved just as a percentage of risk factors are present in any sort of procedure. The surgeon can discuss the case-specific short-term risks involved like wound infection, stroke, heart attack, kidney injury, excessive bleeding, and arrhythmia etc, several long-term risks which happen in rare cases include failure of transplanted valuable and hence requiring another operation for the same.
Q: Is aortic valve replacement surgery considered as an open heart surgery?
A: In this surgery, the removal of a damaged valve and its replacement with an artificial valve is done. The valve replacement surgery is a typical open -heart surgery although, catheter procedure or a minimally invasive method can be an option for few people but not all. The physician can be the best person to suggest what is best for you to undergo.
Q: Will there be any scar after surgery?
A: Some scarring is unavoidable. In open chest surgery, size of the scar is bigger nearly between 6-12 cm, however, in a minimal incision procedure the scar is minimally visible due to its size of 2-6 cm as well as its location makes it less prominent.
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